Two major parts of our economy, health care and housing, are in crisis. I believe this represents an opportunity because the two are linked. A major cause of inability to meet mortgage payments is known to be high health care bills. And high medical costs can be linked to unhealthy housing conditions. One focus of health care reform is prevention, and one form of prevention involves investing in green healthy housing, which will produce major health care savings as shown in many studies, including those reviewed here.
Similarly, weatherization of homes is often cited as the “low-hanging fruit” in reducing greenhouse gas emissions associated with heating and cooling buildings. This is also the subject of a new World Health Organization report on “Health and the Green Economy: Co-Benefits to Health of Climate Change Mitigation (Housing Sector).” We also need better indicators of what green healthy housing looks like and how consumers can recognize it. One major way to accomplish that is to standardize labeling systems for green healthy housing, such as LEED for Homes or Enterprise Green Communities standards. But to do that, we must end the proliferation of green rating systems. Internationally, there are well over 30 such systems. I believe that the best way to standardize these systems is through validation from rigorous scientific studies. But right now, our health research system, principally housed at the National Institutes of Health, does not contain an institute that examines housing. We need a National Institute for Healthy Green Housing to fund independent solid scientific research, which can be expected to produce numerous innovations, as it has for pharmaceuticals and other interventions.
The costs and benefits of green healthy housing need to be quantified. We have completed such cost/benefit analyses for housing interventions associated with childhood lead poisoning and asthma, but this has not yet been done for broader green healthy housing efforts. Such a cost/benefit analysis could help to produce financing mechanisms to expand the resources available for green healthy housing for the vast majority of housing.
Currently, there is some limited funding available for low-income housing (HUD’s Green Sustainability Initiative) and for upper-income housing, but virtually nothing for the broad middle. Financing systems that enable average homeowners to make green healthy housing investments in their own homes will help to create a marketplace that allows for competition and innovation in green healthy housing.
In short, the evidence on how green healthy housing improves health has grown substantially in the past few years. We must act on that evidence and make green healthy housing the norm, not the exception. One way to do this is to persuade government and industry that indoor environmental improvements will have a huge beneficial impact on reducing medical costs. A recent study completed in Great Britain revealed a sevenfold reduction in medical costs directly related to improvements in housing standards.
We should apply all we learned from lead mitigation to all housing hazards—mold, asthma, radon, and injury prevention. Right now, we’re looking into how much money the federal government could save in Medicaid expenses just by improving indoor environmental quality standards—and containing health care costs is a crucial issue now before the nation. Better indoor environmental quality standards should be an important part of that conversation.
David Jacobs, Ph.D., CIH, is director of research at the National Center for Healthy Housing and Vision 2020 chair for Indoor Environmental Quality.